Waterhouse syndrome - Friderichsen: pathogenesis, daryeelka degdegga ah, daaweynta

The qanjidhada adrenal ee jirka ku jira waa xubin muhiim ah hormoonada jidhka. Hormoonnada soo saaray iyaga by saamayn ku soo koobin ee cadaadiska iyo xadiga dareere ah ku wareegaya, heerka cusbada macdanta iyo microelements shaqsi ee heerka dheefshiidka, xataa on qanjirka pituitary ee. Iyo xaaladaha shaqo oo ka mid ah qanjirka yar laakiin aad u muhiim ah waxaa qaba, horumarinta gobolka, oo halis gelinaya nolosha iyo caafimaadka.

Qeexid iyo taariikhda

Waterhouse syndrome - Friderichsen - an la'aan adrenal ba'an, taas oo dhacda ka dib markii dhaawacyada jirka ah hemorrhage ah in ay parenchyma. Taasina waxay keentaa in a xadgudubyo aad u daran deegaanka gudaha ee jirka oo keeni kartaa dhimasho.

Description of xaaladda marka hore u muuqday in 1894, laakiin waxa uu ahaa mid aan dhamaystirnayn, iyo in 1911, Waterhouse tilmaamaysaa shan iyo toban kiis, taas oo ka caawisay inuu isku ururiyaan oo dhan burburiyey. ILAALI isaga oo leh, toddoba sano ka dib, ee 1918, sidoo kale Frederiksen daabacdaa maqaalka ah oo ku saabsan habka this bahal ah.

sababaha

Seynisyahanno ku heshiin in syndrome ee Waterhouse - Friderichsen sababay hemorrhage weyn waqti isku mid ah labada qanjidhada adrenal. ka socda aadka u halista ah - a dhashay, dhallaanka, carruurta iyo dhallinyarada. dabaqa kiiskan ku tacaluqda. gobolka Tani waxa keeni kara bixinta dheer, gaajo ogsijiin uurjiifka ama horumarinta kanaalka dhalmada isticmaalaya birqabato ama shawladda vacuum. Intaa waxaa dheer, door muhiim ah cudurka lagu dhasho daran, iyo dhibaatooyin uurka of gestosis daahay.

Waterhouse syndrome - Friderichsen ee dadka waaweyn waxaa inta badan loo arkaa dhibaato ka mid ah cudur la is qaadsiiyo. Sida caadiga ah, wakiilka waa meningococcus, streptococcus ama stafylokok. Laakiinse kuwanu waa ka sokow, sababaha hemorrhage noqon kartaa nosologies sida jadeecada, qandhada casaan, xummad tiifowga, gawracatada, iyo neoplasms malignant, burooyinka, peritonitis Indvandrerrådgivningen iyo thrombosis xididdada adrenal.

Horumarinta cudurka

qorayaasha badan ayaa go'doonsan this syndrome oo qayb ka ah hab ay qabsiga ah failure horumarinta sepsis ba'an. Laakiin waxaa suurto gal ah in carruurta yar yar iyo haweenka uurka leh hab ka duwan wixii uu yeesho Waterhouse syndrome - Friderichsen. Pathogenesis u muuqato in galleeyda dhiigbaxa badan oo ka mid ah kiliyaha adrenal. Waxay ahaayeen sidaas badan in jirka oo dhan qooyay dhiig, waxaa jira hyperextension kaabsulka, iyo xataa dillaac.

Sida pathogenesis guud, waxaa la muujiyey in foomka of sepsis:

- qalintaanka la'egayah iyo arterioles;
- fahmayaan sarkhaan syndrome,
- joogitaanka meningitis saameen ama meningoencephalitis;
- in la kordhiyo qanjidhada gobol iyo thymus.

symptomatology

Waterhouse syndrome - Friderichsen qaba cudurka meningococcal laga yaabaa in si lama filaan ah ee asalka ah ee fayo-qabka. Waxa uu si degdeg ah in qof u dhiman karo maalmood gudahood horumar.

Waxaa dhammaan bilaabataa excitability xad-dhaaf ah, caro iyo madax xanuun. Markaasuu ku biiro calool xanuun, lalabo, matag iyo shuban. Haddii xanuunka waa mid aad u daran, dhakhtarka la tuhunsan yahay waxaa laga yaabaa in dadka qaba cudurada qalliinka ba'an. Markii hore, xummad-fasalka yar yahay, laakiin kaliya dhowr saacadood ee bilawga waa 39-40 degrees. Sababo la matag iyo shuban jidhka biyaha iyo macdan ka tago, taas oo horseedaysa in ay carqalad ah wadnaha, maskaxda iyo xubnaha kale ee muhiimka ah ka. In dhamaadka, qofka u lumiya miyir iyo dhacaa kooma.

Waxaa jira nooc kale oo cudurka, taas oo u muuqato in ay ku dhacaan af badan ee dhiig karka ama burburkii. Calaamadaha kale waxaa laga yaabaa in aanay noqon at dhan. Man marka hore waa in hurudda ah, laakiin sida hypoxia si deg deg ah uga sii darayo yimaado hurudda oo kooma. Dhinto oo aan dib miyir.

Waterhouse syndrome - carruurta Friderichsen horumariyo si ka dhaqso badan dadka waaweyn, iyadoo aan loo eegin sababta. Marka la eego awoodda ay u leeyihiin magdhawga ee u shaqeeyo si degdeg ah u wiiqmeen, iyo nidaamyada badan iyo xubnaha ayaa weli ku jira geeddi-socodka dhismaha iyo horumarinta, natiijada yimaado maalmood ee ugu horreeya bilawga cudurka.

Baadhista xanuunada

Waterhouse syndrome - Friderichsen sidaas si degdeg ah in dhakhaatiirta inta badan ma haysan waqti si ay u qabtaan baaritaan buuxa oo bal arag waxa ku dhacaya nin soo koraya. Haddii qolka xaaladaha degdegga ah dhakhtar waajib ka shakisan tahay cudurada this, daaweynta isla markiiba bilaabmaa, iyo ogaanshaha biiray ee geedi socodka, maxaa yeelay, account waa on saacba.

Laboratory for xaqiijinta cudurka loo baahan yahay in la helo in falanqaynta guud ee dhiiga:

- leukocytosis iyo wareeg leftward ee caanaha,
- hoos u dhac ku gulukooska ee dhiigga,
- Torombositobiiniya iyo xinjirowga hooseeyo;
- yareynta electrolytes,
- kordhay nitrogen HOL dhiigga.

Si kastaba ha ahaatee, tilmaamayaasha kuwanu ma gaar ah oo u noqon karaan wax caddaynaya ee tiro balaadhan oo ah qalliinka iyo cudurada systemic. Si loo hubiyo, aad u baahan tahay in si taxadar leh u soo ururin taariikhdaada caafimaad, iyo fuliyaan dalool lumbar ah iyo si uu u sharaxo status dareemayaasha. Laakiin waxan oo dhan ayaa la sameeyaa ka dib markii xasilinta xaaladda aadanaha.

cudurka kala duwan

Waterhouse syndrome - waa la kala duwanaayeen Friderichsen ka xaalado caloosha qalliin sida qabsinka ba'an, pankreatit ba'an, daloolin boog caloosha ah ama malawadka. U hubso in dhakhtarku waa inuu hubiyo calaamado meningeal, si looga hortago dhiig maskaxda, thrombosis sanka cavernous. Marka foomka ECG wadnaha caawin doonaan inaad fahamto haddii qofku qabo wadno ama ma.

daaweynta

In meesha ugu horeysa ka dib "syndrome Waterhouse - Friderichsen" cudurka waa in magdhow bukaanka sweated electrolytes dareere ah iyo la'aanta hormoonada adrenal. Si taas loo soo bandhigay ilaa nus litir "hydrokortisoni" ama 120 milligram "prednisolone" helaan arooriyaha iyo saddex garaam oo glucose boqolkiiba shan iyo toban millilitir oo shan xal boqolkiiba ascorbic acid. Sidaas awgeed, waxaan u dhaqmaan on pathogenesis aasaasiga ah, taasoo keenta Waterhouse syndrome - Friderichsen. daryeelka degdegga ah waqti isku mid ah hagaajinaysaa rheology dhiig, dilutes u kordhiyaa qadarka nidaamka dareeraha iyo kordhiyaa cadaadiska. A hormone steroid ka caawiyaa si ay u ilaaliyaan cadaadiska heerka saxda.

Ka dib markii xasilinta hormoonnada ku sii in loo maamulo intramuscularly, "hydrokortisoni" of 50-75 mg lix saacadood ee kasta, iyo copolymer deoxycorticosterone on toban millilitir saddex jeer maalintii. U hubso in la raaco tilmaamayaasha cadaadis iyo, haddii loo baahdo, si wareemo up "epinephrine," "Mezaton" glycosides wadnaha.

Haddii sababta cudurka waxa uu noqday cudurka ah, sida meningococcal, marka lagu daro therapy hoose, bukaanka waxaa la siiyaa antibiotics. Marka celinta bukaanka si caadi ah, hormoono bilaabaan inay si tartiib tartiib ah loo yareeyo qiyaasta. Waxaa muhiim ah in si fiican loo diyaariyo jidhka waxa uu si madax banaan waa in ay soo saaraan glucocorticoids. Ha jir- baajinin daawooyinka, waxaa keeni kara dhibaatooyin labaad.

Waxaa muhiim ah si loo xaqiijiyo in bukaanka uu ahaa kaliya Waterhouse syndrome - Friderichsen. daaweynta laftiisa noqon karaan kuwo khatar ah sida daadadka xad-dhaafka ah ee jidhka ah keena bararka systemic, oo ay ku jiraan bararka cerebral, iyo qaadasho badan oo hoormoonka waxay keeni karaan xanuunada dhimirka. Sidaa darteed, xaaladda bukaanka waa mid aad u muhiim ah in si joogto ah loola socdo oo la qabsato ballanta sida ay baahida uu.

Odoroska

Waterhouse syndrome - Friderichsen - cudurada aad u daran, ayaa muujinaya in mar walba aan waqtiga sababta oo ah noocyo kala duwan oo ka mid ah calaamadaha non-gaar ah. Natiijada ma ku xiran tahay oo kaliya oo ku saabsan sida si fiican u dhaqmaan doonaa dhakhtar ku jirto xaalad degdeg ah, laakiin sidoo kale on heerka uu burbur ku dhaca qanjidhada adrenal iyo awooda magdhawga ee u shaqeeyo. Inta dhameystirka cudurkan waa loo dhintaa.

ka hortagga

Tani waa inta badan tallaabooyin anti-faafa ee qoryaha cudurka taas oo qofka bukaanka ah laga helo cudurka meningococcal. dhakhtarka ayaa shaaca ka qaaday bukaanka noocan oo kale ah waxaa waajib ku ah inay u wargaliyaan kormeerka sanitary iyo go'doomiyo bukaanka. In saddexda maalmood ee soo socda, jeeg dadka xiriirka jiritaanka cudur iyo karantiil ee bulshada shaqada ama hay'ad waxbarasho muddo toban maalmood ah. Taxadar ahaan, dadka xiriirka dhow la leh bukaan-socodka, qori kooras gaaban oo antibiyootig ah.

saf-

Waterhouse syndrome - Friderichsen, nasiib daro, cudurada wax caadi ah. In wadamada horumaray, dhacdooyinka cudurka meningococcal waa 1-3 xaalado per 100 000 dadka. Iyo in ka badan kala badh kiisaska - carruurta da'da xannaanada. Intaa waxaa dheer, toban sanno oo uu arkay u kaca ee dhacdooyinka. Tan waxa u sabab isbedel ayaa ka mid ah dadka pathogene iyo difaac hoos.

statistics Kuwanu waa run badan tahay ma, sida kiisas badan oo tag, maxaa yeelay, baarin astaamaha iskutallaabta. Waterhouse syndrome - Friderichsen sidaas si degdeg ah in dhakhaatiirta aadan waqti si ay u fuliyaan tiro ku filan oo baaritaan koraya.